Anesthesiology Digest: News from April 2022.
Anesthesiologist Pay Jumps 8%
April 19, 2022
Anesthesiologist pay jumped nearly 8 percent from 2021 to 2022, according
to Medscape’s “Physician Compensation Report 2022,” released April 15.
Medscape collected responses from 13,000 physicians across 29 specialties from Oct. 5, 2021,
through Jan. 19, 2022.
Five stats to know:
To read more, go to Medscape.
CMS Opens On-Line IDR Portal for Claims Under the No Surprises Act
April 18, 2022
On Friday, April 15, 2022, the Centers for Medicare & Medicaid Services (CMS) opened the Federal Independent Dispute Resolution (IDR) portal which allows providers to initiate the IDR process under the No Surprises Act to resolve payment disputes with insurers for certain out-of-network charges.
Stakeholders will have a 30-business day period for open negotiations to come to a goodfaith agreement. After the 30-business day open negotiations period, the initiating parties have 4 business days to initiate a dispute via the portal.
Due to the recent ruling in Texas Medical Association, et al. v HHS, disputing parties whose open negotiation expired before April 15, 2022 will have 15 business days (until May 6) to file an initiation notice via the IDR portal. Standard timelines will apply for claims currently in the open negotiations period. Disputing parties can continue to negotiate even after starting the IDR process until the IDR entity makes a determination. Disputing parties with extenuating circumstances can request an extension by contacting the departments via email at FederalIDRQuestions@cms.hhs.gov.
ASA members are also encouraged to share their experiences in using the portal. Notifying ASA of issues related to ease of use and functionality will be helpful as ASA continues to work with Congress and the regulating entities to ensure that the IDR process works properly and facilitates users receiving appropriate payments from insurers. Information should be sent to NoSurprises@asahq.org.
To read more, go to ASA’s website.
Wisconsin Governor Vetoes Dangerous APRN Legislation – Protects Patients in the Badger State
April 16, 2022
WSA supported veto maintains physician involvement in advanced practice nursing care, protecting patients and maintaining the care team model.
ASA commends Wisconsin Gov. Tony Evers for his leadership and dedication to patient safety demonstrated by his veto of Senate Bill 394 (SB 394), a measure that would have significantly expanded scope of practice for advanced practice registered nurses (APRNs) by eliminating current requirements for physician collaboration with all APRNs, including nurse anesthetists. This bill would have actively dismantled the care team model of health care that makes Wisconsin a leader in patient care by allowing nurse anesthetists with far less training and clinical experience than physicians to provide anesthesia care and pain management without physician involvement.
After careful consideration and recognizing the important role nurses play in Wisconsin’s healthcare system, Gov. Evers vetoed the measure because he opposes “altering current licensure standards for APRNs, allowing practices functionally equivalent to those of physicians or potentially omitting physicians from a patient’s care altogether notwithstanding significant differences in required education, training, and experience.” His full message can be found here.
To read more, go to ASA’s website.
Biden Admin Announces Plans to Alleviate Medical Debt Burden
By Victoria Bailey | April 13, 2022
The Biden-Harris administration has announced a series of reforms that aim to alleviate medical debt burden and increase consumer protections for Americans.
One in three adults across the country has medical debt, which can lead to several financial and health challenges. Individuals may avoid seeking healthcare services for fear of furthering their debt.
Past-due medical bills may also appear on consumer credit reports, which can lower consumer credit scores and make it difficult for individuals to access credit, employment opportunities, and secure housing.
The Biden administration’s plan to address the burden of medical debt includes a directive from HHS Secretary Becerra on medical billing practices. Becerra will direct HHS to evaluate how provider billing practices affect care access and affordability, the announcement stated.
HHS will request data from more than 2,000 providers that detail medical bill collection practices, lawsuits against patients, financial assistance, financial product offerings, and third party contracting or debt buying practices.
The Department will consider this information and publicly publish data and policy recommendations regarding medical bill collection practices. In addition, HHS will inform enforcement agencies of potential violations.
The Consumer Financial Protection Bureau (CFPB) also plans to investigate credit reporting companies and debt collectors that violate patient rights and hold the violators accountable. In addition, CFPB will monitor credit reporting and determine if credit reports should include past-due medical bills.
CFPB will also increase its consumer education tools to help individuals and families better understand medical billing processes, including materials and resources specifically designed to help consumers access financial assistance.
Data has shown that medical debt is not a good indicator of credit quality, the announcement noted.
Three nationwide credit reporting agencies—Equifax, Experian, and TransUnion—recently announced that they will remove nearly 70 percent of medical debt collection tradelines from credit reports and will no longer list past-due debt under $500.
However, a third of Americans have medical debt over $500, with 11 million reporting debt over $2,000 and 3 million with debt that exceeds $10,000.
To address this, the Biden administration has provided guidance to all agencies to eliminate medical debt as an underwriting factor in credit programs.
To read more, go to Revcycle Intelligence.
HHS Extends COVID-19 Public Health Emergency for Another 90 Days
By Robert King | April 13, 2022
The Department of Health and Human Services (HHS) has extended the COVID-19 public health emergency for another 90 days and potentially for the final time.
The PHE, which gives key flexibilities to providers and states, will not expire in July. The PHE was originally expected to expire April 16.
It remains unclear whether HHS will extend the emergency for a second time this summer, but providers will likely know the answer in a month. HHS Secretary Xavier Becerra has promised a 60-day heads-up to providers and states that the PHE will end.
The PHE went into effect in 2020 at the onset of the pandemic and granted major flexibilities to providers and states. It gave more flexibility to providers to waive key reporting requirements and removed barriers to telehealth reimbursement under Medicare.
In addition, states may not drop anyone off Medicaid rolls for the duration of the PHE. States are readying to examine thousands of Medicaid enrollees to redetermine whether they are eligible.
Some members of Congress and provider groups have wanted HHS to give even greater lead time, but Becerra has indicated he will not go beyond the 60 days. He has also previously said any decision will be based on the science and the status of COVID-19 in the country.
COVID-19 cases have spiked in recent weeks due to a new subtype of the omicron variant.
To read more, go to Fierce Healthcare.
Startups Eye Cash Pay to Tackle Rising Employer Healthcare Costs
By Nona Tepper | April 12, 2022
A growing number of startups think they have found the solution to employers rising healthcare costs: cash.
Sidecar Health launched its first fully insured health plan for companies on Monday, after opening its first plan for self-insured employers at the beginning of 2022. Cash pay competitor Sesame jumped into the employer fray in February, launching a virtual plan for small- and medium-sized businesses. Friday Health Plans said it grew its membership more than 300% year-over-year in part by focusing on employers that wanted to offer individuals a stipend to buy coverage off the Affordable Care Act exchanges.
Hospitals often set lower, discounted cash prices for common procedures than their insurernegotiated rates, according to a recent study published in JAMA Network Open. By taking advantage of these rates, Sidecar claims the new plan will save employers an average of 39% compared with traditional health insurance companies. Direct-pay also eliminates the administrative burden doctors and patients face when navigating the traditional insurance industry, said Dan Korpman, Sidecar’s head of business development.
The company already counts at least one, Ohio-based company as a customer of its selfinsured plan, Korpman said. During Sidecar’s last funding round in January 2021, the startup was valued at more than $1 billion.
“The user experience is very much like Expedia,” Korpman said. “It’s actually the experience that you have paying for pretty much anything else. You search for the price, shop for care, go get the care and you pay for the service.”
To read more, go to Modern Healthcare.
Providers Given Chance to Request Extra PRF Reporting Time
By Maya Goldman | April 6, 2022
Providers that didn’t report on Provider Relief Fund money they received in the first round because of “extenuating circumstances” have an opportunity to request additional time, the Health Resources and Services Administration announced Wednesday.
Severe illnesses or deaths of employees responsible for reporting, natural disasters that damaged records or technology near the end of the reporting period, internal miscommunication about reporting and failures to click “submit” count as extenuating circumstances that warrant extra time to report after the deadline, according to HRSA.
Providers that didn’t have correct email or mailing addresses on file and subsidiaries that didn’t report targeted distributions are also eligible for the extension.
The original Period 1 reporting deadline was Sept. 30, but funding recipients got a 60-day grace period until Nov. 30, plus an additional week in December, to provide the required information.
HRSA informed noncompliant providers last month that they’d need to repay undocumented Provider Relief Funds within 30 days of that notice.
The American Medical Association and other provider groups last week urged the agency to reopen the portal for another 60 days.
To read more, go to Modern Healthcare.
10 Best Med Schools for Anesthesiology for 2023
By Patsy Newitt | April 5, 2022
Boston-based Harvard University is the No. 1 medical school for anesthesiologists, according to U.S. News and World Report’s list of best medical schools for 2023.
The medical school rankings, released March 28, are based on faculty resources, the academic achievements of entering students and qualitative assessments by schools and residency directors.
The top 10 programs for anesthesiology:
To read more, go to Becker’s ASC Review.
Change Healthcare, UnitedHealth Extend Healthcare Merger Deadline
By Victoria Bailey | April 5, 2022
Change Healthcare and UnitedHealth Group’s diversified health services company, Optum, have announced that they will extend their healthcare merger agreement to December 31, 2022.
UnitedHealth Group first announced plans for Optum to acquire Change Healthcare in January 2021.
In a proposed transaction valued at $8 billion, the merger aimed to combine Change Healthcare’s revenue cycle management technologies with Optum’s services to ease clinician workflow, improve provider access to clinical data, and streamline payment processes.
The companies had expected to finalize the deal in the second half of 2021, but the transaction hit a series of roadblocks.
Most recently, the Antitrust Division of the Department of Justice (DOJ) filed a civil lawsuit to block the merger deal. The complaint stated that the transaction would hurt competition in the commercial health insurance and healthcare technology markets.
DOJ claimed that UnitedHealth Group would gain access to rival payer information, giving the health plan an unfair market advantage. Additionally, the merger would eliminate UnitedHealth Group’s only significant rival for first-pass claims editing technology, allowing the payer to develop a monopoly share in the market.
Change Healthcare and Optum said that DOJ’s attempt to block the merger is “without merit and serves only to delay improving the experience and outcomes for all participants in the health system.”
Since the initial merger announcement, the companies had pushed the deadline to April 2022, but have now extended it to December 2022.
“The extended agreement reflects our firm belief in the potential of our combination to improve healthcare and in our commitment to contesting the meritless legal challenge to this merger,” the companies said in a joint statement.
Change Healthcare and Optum plan to detail the benefits of the merger deal at a two-week trial scheduled to begin on August 1.
To read more, go to Revcycle Intelligence.
Providers Brace for Financial Hits as COVID-19 Uninsured Fund Ends
By Nona Tepper | April 4, 2022
Safety-net hospitals, federally qualified health centers and laboratories may have to cut staff and hours and limit patient access if Congress and President Joe Biden cannot come to an agreement over further COVID-19 pandemic relief.
The COVID-19 Uninsured Program is an early casualty of the budget impasse between lawmakers and the White House, which initially requested $22.5 billion for ongoing COVID-19 response. Laws enacted by Biden and by President Donald Trump authorized this program, which began in 2020, to ensure providers be paid for administering COVID-19 care to U.S. residents without health coverage, who number an estimated 28 million.
The federal government has paid out more than $17 billion to providers for testing, treating and vaccinating the uninsured. The Health Resources and Services Administration ran out of money for the program March 22 and stopped reimbursing providers for COVID-19 testing and treatment. Starting Tuesday, HRSA will no longer pay providers for vaccinating uninsured individuals.
“If we’re put in a position of having to chase payment that might not materialize, then it becomes more a question of, ‘As a lab, do I continue to offer this service?'” said Tom Sparkman, senior vice president of government affairs and policy at the American Clinical Laboratory Association.
Last year, the trade association’s members performed 8 million tests on uninsured patients, Sparkman said. During the omicron wave in January and February, these labs performed 1 million tests on patients who lacked coverage.
Without reimbursement, Curative will no longer be able to offer free testing in some of the 18 states where it operates in, a spokesperson wrote in an email. The company debuted in early 2020 with a focus on sepsis patients, but pivoted to COVID-19 testing when the pandemic started. Curative did not respond to interview requests about the policy’s financial impact or where it will no longer provide no-cost testing to uninsured people.
Quest Diagnostics will begin charging uninsured individuals $100 per test, the company announced. In 2021, COVID-19 testing accounted for one-fifth, or $2.8 billion, of the company’s $10.8 billion in revenue.
To read more, go to Modern Healthcare.
State-based ACA Exchanges Make Backup Plans In Case Congress Fails to Act on Enhanced ACA Subsidies
By Robert King | April 1, 2022
The Biden administration and states across the country celebrated record-breaking enrollment gains for the Affordable Care Act (ACA) this year.
But state-run exchanges are eyeing backup plans for outreach and marketing in case Congress doesn’t extend beyond this year a major driver for those enrollment gains: enhanced income-based subsidies. Some officials have warned that people could drop off coverage—and consumers may shift to less-generous plans—if Congress doesn’t act in time.
“If we are still in this stage of uncertainty, we will have to anticipate either outcome and ramp up planning efforts … with both scenarios in mind,” said Zachary Sherman, executive director of the exchange called Pennie, in an interview with Fierce Healthcare.
Sherman said Pennsylvania’s exchange signed up more than 110,000 new customers compared to the last open enrollment, and 35,000 of those customers are getting subsidies that they typically would not be eligible for.
The American Rescue Plan’s (ARP’s) enhanced subsidies ensured that anyone making more than 400% above the federal poverty level wouldn’t pay more than 8.5% of their income on healthcare. Previously, that was the cutoff for eligibility for income-based subsidies. The enhancements also ensured that some consumers qualified for zero premiums or $10 a month premiums.
According to a recent Assistant Secretary for Planning and Evaluation report, an estimated 3.4 million Americans currently insured in the individual market would lose coverage and become uninsured if the ARP’s premium tax credit provisions are not extended beyond 2022.
Kaiser Family Foundation determined premiums would more than double for many.
Pennie isn’t the only exchange that saw massive gains thanks to the subsidies.
Washington’s exchange saw nearly 60,000 residents sign up for coverage for 2022, and 73% of all customers were eligible for subsidies, up from 61% in 2021, the exchange told Fierce Healthcare.
It added that over 100,000 of the exchange customers (42% of total enrollment) pay $100 or less a month, compared to 29% before the ARP was signed into law.
Customers signing up on state-run exchanges saw average premium savings of 7% to 47% for 2022, according to a report from the National Association for State Health Policy. The report added that at least eight exchanges had 20% or more of their customers paying less than $25 a month for coverage.
Overall, there were 14.5 million people who signed up for coverage for 2022 when considering both the state-run exchanges and the federally run HealthCare.gov, a record number. Now, though, states are grappling with how many people could lose coverage if the extra subsidies go away.
To read more, go to Fierce Healthcare.
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